Youth Camp Junior Camp

Parent or Guardians Name

Address

City Prov SK AB MB BC ON Postal Code

Email address

Home Phone

Camp Fees $

Health Form

 Other Medical Insurance group and policy #

Does applicant have any health condition or problems restricting camp activity? NO YES

If "YES", Please describe

Convulsions     Bed-wetting    Other

Is applicant on medication? NO YES If "YES", explain:

Is applicant on special diet? NO YES If "YES", explain:

Does applicant have allergies? NO YES If "YES", explain:

Family Doctor (Name) Phone:

Emergency contact   Phone:

Other comments 

Waiver Form

This form must be completed for all junior and youth camps.

As part of our continuing effort to assure a safe and secure camp for all our campers, we need the following form filled out and signed before your child/ren will be accepted into our camp.

Are there any members of your immediate or near family that are not allowed to pickup your child?  Note that only family members will be allowed to pickup your child, unless prior arrangements have been made.

Our camp typically consists of a number of outdoor activities.  These include, but not limited to boating, swimming, and  horseback riding.  Do you allow your child/ren to participate in all activities?   Choose Yes No

We often have field trips or special events at our camps.  Do you allow your child/ren to participate in these events?

Choose Yes No

I give ELBC permission to use photos of my child participating in camp events and activities
on its website and in print for publications and/or occasions.
Yes No

Do you require a receipt for income tax purposes?
Yes No

Information collected in this form is used only for Echo Lake Bible Camp to provide a safe and effective camping program.
All information is held in the strictest confidence.

**Be sure to verify that all information is correct before continuing!**